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No serological evidence of influenza A H1N1pdm09 virus infection as a contributing factor in childhood narcolepsy after Pandemrix vaccination campaign in Finland.
PLoS One. 2013; 8(8):e68402.Plos

Abstract

BACKGROUND

Narcolepsy cataplexy syndrome, characterised by excessive daytime sleepiness and cataplexy, is strongly associated with a genetic marker, human leukocyte antigen (HLA) DQB1*06:02. A sudden increase in the incidence of childhood narcolepsy was observed after vaccination with AS03-adjuvanted Pandemrix influenza vaccine in Finland at the beginning of 2010. Here, we analysed whether the coinciding influenza A H1N1pdm pandemic contributed, together with the Pandemrix vaccination, to the increased incidence of childhood narcolepsy in 2010. The analysis was based on the presence or absence of antibody response against non-structural protein 1 (NS1) from H1N1pdm09 virus, which was not a component of Pandemrix vaccine.

METHODS

Non-structural (NS) 1 proteins from recombinant influenza A/Udorn/72 (H3N2) and influenza A/Finland/554/09 (H1N1pdm09) viruses were purified and used in Western blot analysis to determine specific antibody responses in human sera. The sera were obtained from 45 patients who fell ill with narcolepsy after vaccination with AS03-adjuvanted Pandemrix at the end of 2009, and from controls.

FINDINGS

Based on quantitative Western blot analysis, only two of the 45 (4.4%) Pandemrix-vaccinated narcoleptic patients showed specific antibody response against the NS1 protein from the H1N1pdm09 virus, indicating past infection with the H1N1pdm09 virus. Instead, paired serum samples from patients, who suffered from a laboratory confirmed H1N1pdm09 infection, showed high levels or diagnostic rises (96%) in H1N1pdm virus NS1-specific antibodies and very high cross-reactivity to H3N2 subtype influenza A virus NS1 protein.

CONCLUSION

Based on our findings, it is unlikely that H1N1pdm09 virus infection contributed to a sudden increase in the incidence of childhood narcolepsy observed in Finland in 2010 after AS03-adjuvanted Pandemrix vaccination.

Authors+Show Affiliations

Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland. krister.melen@thl.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23950869

Citation

Melén, Krister, et al. "No Serological Evidence of Influenza a H1N1pdm09 Virus Infection as a Contributing Factor in Childhood Narcolepsy After Pandemrix Vaccination Campaign in Finland." PloS One, vol. 8, no. 8, 2013, pp. e68402.
Melén K, Partinen M, Tynell J, et al. No serological evidence of influenza A H1N1pdm09 virus infection as a contributing factor in childhood narcolepsy after Pandemrix vaccination campaign in Finland. PLoS One. 2013;8(8):e68402.
Melén, K., Partinen, M., Tynell, J., Sillanpää, M., Himanen, S. L., Saarenpää-Heikkilä, O., Hublin, C., Olsen, P., Ilonen, J., Nohynek, H., Syrjänen, R., Kilpi, T., Vuorela, A., Kirjavainen, T., Vaarala, O., & Julkunen, I. (2013). No serological evidence of influenza A H1N1pdm09 virus infection as a contributing factor in childhood narcolepsy after Pandemrix vaccination campaign in Finland. PloS One, 8(8), e68402. https://doi.org/10.1371/journal.pone.0068402
Melén K, et al. No Serological Evidence of Influenza a H1N1pdm09 Virus Infection as a Contributing Factor in Childhood Narcolepsy After Pandemrix Vaccination Campaign in Finland. PLoS One. 2013;8(8):e68402. PubMed PMID: 23950869.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - No serological evidence of influenza A H1N1pdm09 virus infection as a contributing factor in childhood narcolepsy after Pandemrix vaccination campaign in Finland. AU - Melén,Krister, AU - Partinen,Markku, AU - Tynell,Janne, AU - Sillanpää,Maarit, AU - Himanen,Sari-Leena, AU - Saarenpää-Heikkilä,Outi, AU - Hublin,Christer, AU - Olsen,Päivi, AU - Ilonen,Jorma, AU - Nohynek,Hanna, AU - Syrjänen,Ritva, AU - Kilpi,Terhi, AU - Vuorela,Arja, AU - Kirjavainen,Turkka, AU - Vaarala,Outi, AU - Julkunen,Ilkka, Y1 - 2013/08/08/ PY - 2013/02/27/received PY - 2013/05/28/accepted PY - 2013/8/17/entrez PY - 2013/8/21/pubmed PY - 2014/5/3/medline SP - e68402 EP - e68402 JF - PloS one JO - PLoS One VL - 8 IS - 8 N2 - BACKGROUND: Narcolepsy cataplexy syndrome, characterised by excessive daytime sleepiness and cataplexy, is strongly associated with a genetic marker, human leukocyte antigen (HLA) DQB1*06:02. A sudden increase in the incidence of childhood narcolepsy was observed after vaccination with AS03-adjuvanted Pandemrix influenza vaccine in Finland at the beginning of 2010. Here, we analysed whether the coinciding influenza A H1N1pdm pandemic contributed, together with the Pandemrix vaccination, to the increased incidence of childhood narcolepsy in 2010. The analysis was based on the presence or absence of antibody response against non-structural protein 1 (NS1) from H1N1pdm09 virus, which was not a component of Pandemrix vaccine. METHODS: Non-structural (NS) 1 proteins from recombinant influenza A/Udorn/72 (H3N2) and influenza A/Finland/554/09 (H1N1pdm09) viruses were purified and used in Western blot analysis to determine specific antibody responses in human sera. The sera were obtained from 45 patients who fell ill with narcolepsy after vaccination with AS03-adjuvanted Pandemrix at the end of 2009, and from controls. FINDINGS: Based on quantitative Western blot analysis, only two of the 45 (4.4%) Pandemrix-vaccinated narcoleptic patients showed specific antibody response against the NS1 protein from the H1N1pdm09 virus, indicating past infection with the H1N1pdm09 virus. Instead, paired serum samples from patients, who suffered from a laboratory confirmed H1N1pdm09 infection, showed high levels or diagnostic rises (96%) in H1N1pdm virus NS1-specific antibodies and very high cross-reactivity to H3N2 subtype influenza A virus NS1 protein. CONCLUSION: Based on our findings, it is unlikely that H1N1pdm09 virus infection contributed to a sudden increase in the incidence of childhood narcolepsy observed in Finland in 2010 after AS03-adjuvanted Pandemrix vaccination. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/23950869/No_serological_evidence_of_influenza_A_H1N1pdm09_virus_infection_as_a_contributing_factor_in_childhood_narcolepsy_after_Pandemrix_vaccination_campaign_in_Finland_ L2 - https://dx.plos.org/10.1371/journal.pone.0068402 DB - PRIME DP - Unbound Medicine ER -